Tammy Rich, an RN care coordinator, helped me break through a barrier I could not have overcome alone. I use an insulin pump, and my basal rate is set to manage based on my daily activities. With my children returning to school and my spouse transitioning to remote work, the days were less predictable. Living with type 1 diabetes is not as straightforward as managing diet, exercise, and insulin injections. I received my first three-month order of insulin pump supplies and was stunned by the steep $1500 out-of-pocket cost. Immediately, I halted the automatic shipments, deciding to stretch the supply until I had time to pay off the expense before ordering more. Because I was using infusion sites longer than recommended, my scarring increased, the insulin didn’t absorb as well, and I struggled with frequent high blood sugar.

Shortly after my routine diabetes appointment, I received a call from Tammy Rich. She let me know that I had been enrolled in care management to help with my diabetes. I was worried that hers would be just another voice telling me things I already knew -- “eat right, exercise, take your insulin”. But Tammy surprised me. She began asking questions about me and how I had been managing my diabetes. While I shared the details, she stayed engaged, genuinely curious to learn about me and my experience, which put me at ease. I started to feel comfortable talking to her, so when she asked, “How can I help you?” I felt like I could trust her with where I was struggling most. My most immediate need was to alleviate the financial burden of my insulin pump supplies. She assured me that she would look into ways to help make the supplies affordable, and we planned to talk again in a week. On our next call, she shared some big news. Her investigation revealed that my insurance coverage for insulin pump supplies should have been covered at 100% with $0 out of pocket cost to me; furthermore, she had initiated a ticket with my insurance to see why my January order did not reflect that coverage. 

The next call I received from Tammy was two days ahead of schedule - she had even bigger news that just could not wait until our upcoming call. She had heard back from the insurance company. They confirmed the claim was processed incorrectly, there should have been no charge to me. The claim was being corrected, and the charge would be removed. I was overwhelmed with relief. Still, Tammy had gone even further in her investigation. She found out that while my pump supplies are not covered at 100%, the max out-of-pocket cost for the year was only $250, which seemed like pennies compared to the previous charge of $1500. For the first time in a long time, I felt myself come up for air. The same day I got this exciting news, I not only submitted a request for a fresh shipment of pump supplies but also set up my orders for automatic delivery. Tammy met me where I was and helped me break through a barrier I could not have overcome alone.